I've read descriptions/photos where one or the other is used, but not both simultaneously (maybe they did this for ease of explanation). I'm Asian and this would be beneficial in my case where I want a projected tip (extended columellar strut) and an augmented "tethering" look to my subnasale (caudal extension with the with the longer side on the inferior end). My upper lip is not retrusive and it only tilts back very very slightly, but still want a little more push for the tethering look. Thank
Can Extended Columella Strut and Caudal Extension Grafts Be Used Simultaneously?
Doctor Answers 2
Combined septal extension columellar strut graft
These grafts are often used at the same time as a combined septal extension/columellar strut graft. The nose can be lengthened at the same time the tip is projected and counter-rotated. A retruded columella can also addressed with this combined graft.
In Asian rhinoplasty, a strut and extension graft is not needed simultaneously
An extended columellar strut can be shaped to extend the septum both caudally and to give tip support. So you can use either a caudal extension strut to lengthen the nose, or you can use an extended strut to both lengthen the tip and give open up the acute angle. Rarely would you need both.